Chronic pain is a widespread problem that affects a third of Americans and greatly burdens the health care system. Despite its prevalence, chronic pain remains poorly understood, and the current clinical strategies are minimally effective. The application of advanced neuroimaging techniques to the study of chronic pain has significantly increased our understanding of the brain?s role in the development and maintenance of chronic pain, and through these studies, researchers have uncovered previously unknown neural processes involved in pain chronification. The spinal cord is the caudal extension of the brainstem and is actively involved in the modulation and transmission of neural signals between the body and the brain. Alterations in the neural processing in the spinal cord are also thought to have an integral role in pain chronification. Recent advancements in spinal cord neuroimaging have made the quantitative study of the spinal cord?s role in chronic pain possible. Expanding the neuroimaging-based investigation of chronic pain to the spinal cord will provide a complete perspective of the central processes underlying pain chronification. In this mentored career development award (K23), Dr. Weber will identify, characterize, and longitudinally track neuroimaging-based biomarkers for chronic pain in the brain and spinal cord using cervical radiculopathy as a model condition for chronic pain. Cervical radiculopathy is a common cause of neck and upper limb pain and provides a unique opportunity to scientifically study chronic pain in a homogenous patient sample. In Aims 1 and 2, Dr. Weber will identify differences in the brain and spinal cord networks between patients with chronic pain due to right-sided cervical radiculopathy and age- and sex-matched healthy controls. In Aim 3, clinical measures in the same cohort of cervical radiculopathy patients will be longitudinally tracked at 3, 6, 9, and 12 months after the imaging session, and neuroimaging-based prognostic factors contributing to pain reduction in cervical radiculopathy will be identified. In the same cohort of patients, the imaging will be repeated at 12 months, and the links between the changes in the brain and spinal cord and recovery will be explored. This research will move the pain field forward by further elucidating the neural processes underlying chronic pain and its recovery. Throughout the award period, Dr. Weber will obtain new skills and expertise in conducting clinical studies including randomized controlled trials and applying advanced computational methods to clinical pain research. Additionally, Dr. Weber will gain further training in advanced neuroimaging methods, pain neurobiology, career development, and grant writing. To accomplish the proposed research and training, Dr. Weber has assembled a multi-disciplinary team of world-class mentors who are committed to his success. This training will build on Dr. Weber?s clinical background and doctoral research training in neuroscience and ultimately provide him with the knowledge and skillset to establish an independent research program, in which, he will lead impactful scientific research that intersects neuroimaging and clinical pain research.